Posts Tagged ‘lung cancer screening’

Dr. Suresh Ramalingam, Professor/Chief of Medical Oncology from the Winship Cancer Insititute, recently conducted an chat pertaining to the leading cause of cancer deaths among both men and women, which is lung cancer.

As many of us are already aware, Dr. Ramalingam reminded participants that secondhand smoke is a known risk factor for the development of lung cancer. Given that exposure to secondhand smoke varies and is difficult to track, it’s also hard to quantify the exact risk second hand smoke has on a person. However, recent studies have shown that states in which laws are in place to restrict public smoking are beginning to report declines in lung cancer incidence.

During the live chat, Dr. Ramalingam also touched on lung cancer treatment options and noted that there is no one-fits-all approach to treating a disease like lung cancer. Ideal treatment methods vary based on the stage of the disease. For early stage lung cancer, surgery is considered the standard treatment, however Dr. Ramalingam noted that some researchers believe stereotactic radiation will one day replace the need for surgery. Dr. Ramalingam added that radiation can also be a very effective treatment option for patients who are not candidates for surgery due to medical reasons. Chemotherapy has shown effectiveness in nearly all stages of lung cancer.

There’s great news for former smokers and the concern of developing lung cancer. Once a smoker quits, the risk of lung cancer progressively decreases. (For a timetable on the benefits of quitting, check out our blog post here) Recently, lung CT scans have demonstrated the ability to save lives in patients who currently smoke, or who have a history of smoking. Dr. Ramalingam suggests that former smokers discuss their smoking history with their physician to see if a lung CT screening is appropriate.

If you would like more information about the causes, prevention and methods used to treat lung cancer you may review Dr. Suresh Ramalingam’s lung cancer chat transcript here.

Doctors Kristin Higgins and Taofeek Owonikoko held a live web chat on the topic of lung cancer this month. From that chat, there were several unanswered questions that we wanted to circle back with the answers for. You’ll find them below in a Q&A format. If you’re interested in checking out the rest of the conversation from the chat, check out the lung cancer chat transcript.

Rhonda asked: Is there any lung cancer treatment program for people without health insurance?

Dr. Owonikoko: Depending on where this person resides, the state may have a program for indigent cancer patients. Also, the American Cancer Society has some patient support programs for indigent patients to support cancer care. Here is the webpage to the support options on the ACS website.

Marjorie asked: My sister has been treated this year for non-small cell lung cancer in the RUL, that was inoperable. she underwent 6 months of radiation and chemotherapy, and has been told that she is now in remission. what are the odds that she will remain in remission for 5 years or more?

Dr. Owonikoko: This is not a medical advice; best to discuss with the treating oncologist. However, depending on the exact stage of the cancer, 20-30% of patients treated with chemoradiation will survive past 5 years.

Marjorie asked: Also, can you comment on outcomes from radiation induced pneumonitis?

Dr. Higgins: Radiation pneumonitis arises in about 20-25% of patients that are treated with radiation and chemotherapy. It typically resolves with a course of steroids but sometimes requires hospitilization for more intensive monitoring and supplemental oxygen.

Hank asked: There seems to be some controversy about the use of radiation therapy for lung cancer depending on the stege. What are the pro’s and con’s?

Dr. Owonikoko: There is not much controversy about the benefit of radiation for patient with locally advanced lung cancer. The discussion is more about the best way to give the radiation and how much. Radiation is generally not needed for patients with stage I lung cancer of the non small cell subtype but may be useful for symptom palliation in patients with stage IV non small lung cancer.

Dr. Higgins can provide additional insight on the radiation questions.

Dr. Higgins: A form of local therapy is needed to cure lung cancer that has not yet spread to distant sites, whether it be radiation or surgery. Surgery is the best option for early stage lung cancer. New techniques of radiation, particularly SBRT, have been used in patients with early stage lung cancer that are not medically fit for surgery. Outcomes have been very good with SBRT, however surgery and SBRT have not been directly compared and surgery remains the standard of care. There are trials underway that are directly comparing SBRT vs. surgery.
Again I want to stress that surgery remains the standard of care for early stage lung cancer, but pros to SBRT include minimal recovery time and a less invasive procedure.

Do you have other questions for us related to lung cancer? Leave them in the comments below & we’ll be sure to post responses here.

More than 46 million Americans smoke cigarettes, despite the fact that tobacco use is the single largest preventable cause of death in the U.S. To help lower this number and the heightened risk for disease caused by cigarette smoking, the American Cancer Society’s Great American Smokeout is Thursday, November 17. The event is held each year to encourage smokers to set a quit date with a community of peers and support.

Along with the Great American Smokeout event, November is Lung Cancer Awareness Month, meaning there are multiple opportunities to make a change and choose to quit smoking today. If the momentum and support created through these events and efforts aren’t enough, there is plenty of data to prove the benefits of quitting smoking today:

Within 20 minutes of quitting, your blood pressure and heart rate are reduced to almost normal.

Within 48 hours of quitting, damaged nerve endings begin to repair themselves, and sense of taste and smell begin to return to normal as a result.

Within 2-12 weeks of quitting, your heart attack risk is lowered.

According to a 2005 study by the National Institute of Health, within 10 years of quitting smoking, your risk of being diagnosed with lung cancer is between 30-50% of that for the smoker who didn’t quit.

According to the American Cancer Society, smoking cigarettes kills more Americans every year than alcohol, car accidents, suicide, AIDS, homicide and illegal drugs combined. It is also responsible for 9 out of 10 lung cancer deaths, a disease that is extremely hard to treat, but that could be prevented.

If you’re interested in discussing lung cancer, including diagnosis and treatment options, in more detail with us, we’re holding a lung cancer web chat this week on the same day as the Great American Smokeout, November 17th. This one-hour web chat is a free event for our community to get your lung cancer questions answered. If you want to participate, fill out this short form to receive your link to join Thursday’s chat.

More people in the U.S. die from lung cancer than any other type of cancer. Lung cancer is responsible for approximately 30% of cancer deaths in the United States. In fact, it’s actually the cause of more deaths than breast cancer, colon cancer and prostate cancer combined. November is Lung Cancer Awareness Month and we’d like to share with you some important information and tips for how you can lower your lung cancer risk.

Quit Smoking

Obviously, if you smoke, the most important step you can take to lower your risk for lung cancer is to quit smoking. Quitting smoking:

Lowers your risk for lung cancer – According to a 2005 study by the National Institute of Health, within 10 years of quitting smoking, your risk of being diagnosed with lung cancer is between 30-50% of that for the smoker who didn’t quit.

Smoking accounts for ~90% of lung cancer cases. If you smoke, this is the critical first step in lowering your lung cancer risk. If you have a history of smoking and are between the ages of 55-75, you may be a candidate for a Lung CT Scan.

Eat a Wider Variety and More Fruits & Veggies

In November 2007, the American Institute for Cancer Research (AICR) and the World Cancer Research Fund published Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective, the most comprehensive report on diet and cancer ever completed. The study found evidence linking diets high in fruit and their ability to lower lung cancer risk to be probable. This is one of the core reasons that the AICR recommends consuming at least five portions a day of fruits and vegetables. After evaluating approximately 500,000 people in 10 countries in Europe, another study demonstrated intaking a variety of produce may also help lower lung cancer risk, so make sure to vary the color on your plate!

Chat Online with Dr. Suresh Ramalingam

If you have specific questions about lung cancer, whether they’re related to prevention, risk factors, symptoms, diagnosis, treatment, support, or otherwise, Dr. Ramalingam is hosting a free 1-hour online web chat about Lung Cancer on Thursday, November 17th. Dr. Ramalingam will also be fielding questions on the topic of Lung CT scanning, a lung cancer screening mechanism that studies have shown may help lower the risk of lung cancer mortality.

You can ask as many questions as you’d like in the chat, or feel free to sign up to check out Dr. Ramalingam’s answers to other participant questions. We hope to see you there! UPDATE: Lung Cancer Chat Transcript

Many people think that cigarette smoking causes only lung cancer. If you are one of them, think again.

A study published just this week in the Journal of the American Medical Association (JAMA) finds that risk of developing bladder cancer – for men and women – is higher among smokers than previously believed.

Doctors such as Dr. Viraj Master, associate professor of urology, Emory School of Medicine and director of clinical urology research at the Winship Cancer Institute of Emory University, see patients every week whose cancers likely were caused by smoking.

“Patients are often surprised to hear of the link between smoking and bladder cancer, but it’s there and it’s real,” says Dr. Master. “Smoking’s effects on the body are both pervasive and lethal.”

How could it be that cigarette smoke gets into your bladder? As it turns out, the actual smoke does not, but the carcinogens in tobacco smoke do get into your blood stream and thus into other parts of your body. The study, authored by researchers at the National Cancer Institute, suggests that an apparent increase in the concentration of carcinogens has occurred in the past 50 years, even as tar and nicotine concentrations have been reduced.

Other cancers caused from smoking include: throat, mouth, nasal cavity, esophagus, stomach, pancreas, kidney, bladder, cervix, and acute myeloid leukemia. If you or a loved one would like help to quit smoking, you can call the Georgia Tobacco Quit Line at 877-270-STOP (7867).

Did you know that only 15% of lung cancer patients survive more than 5 years after their cancer has been identified? As Vicki Griffin of the Atlanta Journal Constitution puts it in a recent AJC article on lung cancer, “The bleak bottom line is that lung cancer overwhelmingly terminates lives within months of the initial diagnosis.” But as Dr. Curran of the Winship Cancer Institute reported weeks ago in a lung cancer blog post, this number could be improved. How, you ask? Through low-dose Lung CT scanning.

A recent 5 year study sponsored by the National Cancer Institute (NCI), which is the same organization that has designated the Winship Cancer Institute as one of only 65 NCI designated cancer centers in the United States, shows that when lung adenocarcinomas are caught in earlier, more treatable stages, lung cancer death rates for those at high risk are reduced by 20%. Based on our knowledge that 157,000 people died at the hands of lung cancer in the U.S. in 2010 alone, this means last year, over 31,000 lives could have been saved.

The study evaluated over 53,000 participants at high risk for lung cancer in 25 states, including Georgia. As part of the evaluation of the effectiveness of low-dose Lung CT scans, the study compared the ability for Lung CT screenings and the currently standard chest X-ray technology to identify lung cancer early on.

Emory was a participant in the NCI sponsored study, and we conducted trials across the state of Georgia. As a result of the study’s significant findings, our teams at the Emory Clinic and Emory University Hospital Midtown are now offering current and former smokers with a significant smoking history high risk for lung cancer an opportunity to get a Lung CT scan at very reasonable rates.

Lung cancer remains the number one cancer killer in the U.S., claiming more lives than the next three most common cancer killers — prostate, breast and colorectal cancers – combined. But Lung CT screening may help with the early diagnosis and ultimately, increased survival rates, for lung cancer patients.

For more information on Lung CT scanning, or to find out if you are a candidate for screening, please visit our newly launched website dedicated to educating our community on Lung CT screening and its benefits. You can also call us for more information at 404-778-7777.

Lung cancer remains the nation’s number one cancer killer, claiming more lives than the next three most common cancer killers — prostate, breast and colorectal cancers – combined. In the U.S. alone, over 157,000 people died from the disease in 2010. That’s more than 3,000 people per week.

One reason for this devastating toll is that no reliable screening test has existed to detect the disease in its early stages. Most cases are diagnosed only after symptoms appear. If lung cancer could be diagnosed before symptoms appear, the cure rate should be much higher.

The article in the NEJM shows there is reason for hope. A study conducted at 33 cancer centers nationwide, including Winship, enrolled more than 53,000 people at high risk of developing lung cancer between August, 2002 and April, 2004. They were randomly assigned to receive either low-dose CT scanning or a chest X-ray as a means to detect lung cancer. Data were collected on the participants through 2009. The findings were significant. Deaths from lung cancer were reduced by 20 percent in the group who underwent the low-dose CT scans.

If we could reduce lung cancer mortality in the U.S. by 20 percent, we’d be saving 30,000 lives a year.

Even so, the findings published in NEJM may not result in an immediate change in CT scan screening guidelines for lung cancer. Screening guidelines of any kind require additional study and evaluation. Further analyses of this trial will also be required.

We have made tremendous strides in the treatment of lung cancer, but we also know that the real breakthroughs will happen when we are able to prevent its development or establish the earliest possible diagnosis. The dialogue on how best to implement low-dose CT scan screening for lung cancer should begin now.

What if there were a way for 32,000 of the 160,000 lives lost each year related to cigarette smoking to be saved? There may just be. Findings from a recent study show the risk of dying from lung cancer could be reduced by 20 percent by use of a low-dose helical computed tomography (CT) scan. In other words, this type of CT screening could save over 30,000 lives a year.

Lung cancer is the leading cause of cancer-related deaths, and as such, cancer research and treatment experts are constantly looking for ways to reduce the pervasive nature of the disease. The National Cancer Institute (NCI) launched the multi-center National Lung Screening Trial (NLST) in 2002. The trial compared two ways of detecting lung cancer using low dose helical (spiral) CT vs a standard chest X-Ray. Part of this research study was actually led at Emory by radiologist and researcher Dr. Kay Vydareny.

The trial aimed to determine the effects of low-dose helical CT scans vs chest X-Rays on lung cancer death rates in high-risk populations. Both chest X-rays and helical CT scans have been used as a means to find lung cancer early, but the effects of these screening techniques on lung cancer mortality rates had not been determined.

Over a 20-month period, more than 53,000 current or former heavy smokers ages 55 to 74 joined NLST at 33 study sites across the United States. In November 2010, the initial findings from NLST were released. The conclusion? Clinical trial participants who received low-dose helical CT scans had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays.

While the benefits of low-dose helical CT scans in the reduction of lung cancer deaths are obvious, not every diagnostic option comes completely risk free. The CT scans can occasionally detect suspicious abnormalities that do not turn out to be lung cancer – known as false positives. Many of these abnormalities are scars from smoking, areas of inflammation or other noncancerous conditions that may require additional testing to determine that they are not harmful. These tests have been known to cause undue anxiety for patients and may sometimes lead to biopsies or surgeries.

“It is certainly an individual’s choice whether they want to be screened for lung cancer with a CT scan if they have no symptoms. However, it is important to make certain that such individuals have complete information and be well-informed before having such a scan. If a patient has symptoms, such as a persistent cough, weight loss, persistent hoarseness or trouble breathing, he or she should see a physician as soon as possible. Often these symptoms are due to something other than lung cancer, but more tests should be performed to make certain,” says Vydareny.

What should a person at high-risk for lung cancer do? The answer that all physicians agree on is to stop smoking right now, the sooner the better. Or even better … don’t start smoking ever, further reducing the chances of getting cancer or suffering from a stroke or heart attack as well.

“All physicians hope that there will be a test that can screen for early lung cancer and that the dismal prognosis of those with lung cancer will improve. Perhaps it will be screening with CT scans. Perhaps it will be a blood test,” says Vydareny. “That day hopefully will come, but it has not yet arrived. But if you are or have been a heavy smoker, your first step should be to consult your primary care physician to discuss all possible screening options.”

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About Winship at Emory

Winship Cancer Institute of Emory University, Georgia’s only National Cancer Institute-designated cancer center, serves as the coordinating center for cancer research and care throughout Emory University and Emory Healthcare. Seeing more than 14,000 patients each year, Winship at Emory offers patients with access to progressive resources, technology and cancer treatment options. To benefit from these investigational advancements in cancer treatment, it is important to seek care from an academic medical center like Winship at Emory, first. Through discoveries made possible by a dedicated team of many of the nation’s best physicians and researchers, Winship at Emory works hard toward a future when science triumphs over cancer.

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